1649263294 JOHN I BARON HAS413 NPI

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1649263294
JOHN I BARON
National Provider Identifiers Registry
The Administrative Simplification provisions of the Health Insurance Portability
and Accountability Act of 1996 (HIPAA) mandated the adoption of standard
unique identifiers for health care providers and health plans. The purpose of these
provisions is to improve the efficiency and effectiveness of the electronic
transmission of health information. The Centers for Medicare & Medicaid Services
(CMS) has developed the National Plan and Provider Enumeration System
(NPPES) to assign these unique identifiers.

2018

National Provider Identifiers Registry

www.hipaaspace.com

1649263294 JOHN I BARON
NPI

1649263294

10-position all-numeric identification number
assigned by the NPS to uniquely identify a health
care provider.

Individual

Code describing the type of health care provider that
is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
N Indicate whether provider is a sole proprietor.
  • A sole proprietor is the sole (the only) owner of a business that is not incorporated; that unincorporated business is a sole proprietorship.
  • In a sole proprietorship, the sole proprietor owns all of the assets of the business and is solely liable for all of the debts of the business.
  • There is no difference between a sole proprietorship and a sole proprietor; they are legally a single entity: an individual.
  • In terms of NPI assignment, a sole proprietor is an Entity type 1 (Individual) and is eligible for only one NPI (the sole proprietorship business is not eligible for its own NPI).
  • As an individual, a sole proprietorship cannot be a subpart and cannot have subparts. (See NPI Final Rule for information about subparts.)
  • A sole proprietorship may or may not have employees.
  • Often, the IRS assigns an EIN to a sole proprietorship in order to protect the sole proprietor's SSN from disclosure in claims or on W2s. NPPES does not capture a sole proprietorship's EIN.
  • Many types of health care providers could be sole proprietorships (for example, group practices, pharmacies, home health agencies).
Provider Last Name (Legal Name) BARON The last name of the provider (if an individual). If the provider is an individual, this is the legal name. This name must match the name on file with the Social Security Administration (SSA). In addition, the date of birth must match that on file with SSA. (First and last names are required for initial applications.) The First, Middle, Last and Credential(s) fields allow the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. Provider First Name JOHN Entity Type Is Sole Proprietor The first name of the provider, if the provider is an individual. -2- National Provider Identifiers Registry Provider Middle Name www.hipaaspace.com I The middle name of the provider, if the provider is an individual. Provider Credential Text MD The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS. Provider First Line Business Mailing Address 19 WOODLAND ST The first line mailing address of the provider being identified. This data element may contain the same information as ''Provider first line location address''. Provider Second Line Business Mailing Address STE 47 The second line mailing address of the provider being identified. This data element may contain the same information as ''Provider second line location address''. Provider Business Mailing Address City Name HARTFORD Provider Business Mailing Address State Name CT The City name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address City name''. The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address State name''. Provider Business Mailing Address Postal Code 06105-2372 The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ''Provider location address postal code''. Provider Business Mailing Address Country Code US The country code in the mailing address of the provider being identified. This data element may contain the same information as ''Provider location address country code''. Provider Business Mailing Address Telephone Number 860-525-4005 The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ''Provider location address telephone number''. Provider First Line Business Practice Location Address 7 ELM ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. Provider Second Line Business Practice Location Address STE 201 The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. Provider Business Practice Location Address City Name ENFIELD The city name in the location address of the provider being identified. Provider Business Practice Location Address State Name CT The State or Province name in the location address of the provider being identified. -3- National Provider Identifiers Registry Provider Business Practice Location Address Postal Code Provider Business Practice Location Address Country Code www.hipaaspace.com 06082-3669 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. US The country code in the location address of the provider being identified. Provider Business Practice Location Address Telephone Number 860-741-6678 The telephone number associated with the location address of the provider being identified. Provider Business Practice Location Address Fax Number 860-741-6272 The fax number associated with the location address of the provider being identified. Provider Enumeration Date 08/30/2005 The date the provider was assigned a unique identifier (assigned an NPI). Last Update Date 08/18/2009 The date that a record was last updated or changed. Provider Gender Code Provider Gender M The code designating the provider's gender if the provider is a person. Male The provider's gender if the provider is a person. Healthcare Provider Taxonomy Code #1 207RC0000X Healthcare Provider Taxonomy 1 Cardiovascular Disease Provider License Number 1 The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. 030174 Provider License Number State Code 1 CT Healthcare Provider Primary Taxonomy Switch 1 Y Healthcare Provider Taxonomy #1 Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. Provider License Number State Code #1 Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
-4- National Provider Identifiers Registry www.hipaaspace.com Other Provider Identifier 1 2083602 Other Provider Identifier #1 Other Provider Identifier Type 1 OTHER Other Provider Identifier Type #1 Other Provider Identifier Issuer 1 AETNA Other Provider Identifier Issuer #1 Other Provider Identifier 2 628620 Other Provider Identifier #2 Other Provider Identifier Type 2 OTHER Other Provider Identifier Type #2 Other Provider Identifier State 2 CT Other Provider Identifier State #2 Other Provider Identifier Issuer 2 CONNECTICARE Other Provider Identifier Issuer #2 Other Provider Identifier 3 OV3354 Other Provider Identifier #3 Other Provider Identifier Type 3 OTHER Other Provider Identifier Type #3 Other Provider Identifier State 3 CT Other Provider Identifier State #3 Other Provider Identifier Issuer 3 HEALTH NET Other Provider Identifier Issuer #3 Other Provider Identifier 4 001301746 Other Provider Identifier #4 Other Provider Identifier Type 4 MEDICAID Other Provider Identifier Type #4 Other Provider Identifier State 4 CT Other Provider Identifier State #4 Other Provider Identifier 5 00130174601 Other Provider Identifier #5 Other Provider Identifier Type 5 OTHER Other Provider Identifier Type #5 Other Provider Identifier Issuer 5 ANTHEM BCBS Other Provider Identifier Issuer #5 Other Provider Identifier 6 010030174CT02 Other Provider Identifier #6 Other Provider Identifier Type 6 OTHER Other Provider Identifier Type #6 Other Provider Identifier Issuer 6 ANTHEM BCBS Other Provider Identifier Issuer #6 -5- National Provider Identifiers Registry Other Provider Identifier 7 www.hipaaspace.com 060052426 Other Provider Identifier #7 Other Provider Identifier Type 7 OTHER Other Provider Identifier Type #7 Other Provider Identifier Issuer 7 RAILROAD MEDICARE Other Provider Identifier Issuer #7 Other Provider Identifier 8 0005252065 Other Provider Identifier #8 Other Provider Identifier Type 8 OTHER Other Provider Identifier Type #8 Other Provider Identifier Issuer 8 AETNA Other Provider Identifier Issuer #8 Other Provider Identifier 9 010030174CT03 Other Provider Identifier #9 Other Provider Identifier Type 9 OTHER Other Provider Identifier Type #9 Other Provider Identifier Issuer 9 ANTHEM BCBS Other Provider Identifier Issuer #9 Other Provider Identifier 10 HAS413 Other Provider Identifier #10 Other Provider Identifier Type 10 OTHER Other Provider Identifier Type #10 Other Provider Identifier State 10 CT Other Provider Identifier State #10 Other Provider Identifier Issuer 10 OXFORD Other Provider Identifier Issuer #10 -6- National Provider Identifiers Registry www.hipaaspace.com NPPES National Plan & Enumeration System 1-800-465-3203 (NPI Toll-Free) 1-800-692-2326 (NPI TTY) NPI Enumerator PO Box 6059 Fargo, ND 58108-6059 Email: customerservice@npienumerator.com -7- National Provider Identifiers Registry www.hipaaspace.com For all questions regarding this bundle please contact Support@HIPAASpace.com. Also feel free to let us know about any suggestions or concerns. All additional information as well as customer support is available at http://www.HIPAASpace.com. -8-

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Create Date                     : 2018:03:03 20:31:35-08:00
Modify Date                     : 2018:03:03 20:31:35-08:00
Title                           : 1649263294 JOHN I BARON
Subject                         : 1649263294 JOHN I BARON
Keywords                        : 1649263294, JOHN, I, BARON
Creator                         : www.hipaaspace.com
Author                          : www.hipaaspace.com
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